WHO issues guidelines on use of ARVs by at-risk HIV-negative people

Washington, DC, US (PANA) - The World Health Organization (WHO) has issued its first guidance to countries that are considering offering HIV medications, known as antiretrovirals (ARVs), to protect people who do not have the virus but who are at high risk of HIV infection.

PANA reports that the guidance was issued Friday in Washington, DC, and Geneva, Switzerland, ahead of the 19th International AIDS Conference is taking place in the US capital city 22-27 July. The theme of the conference is “Turning the Tide Together”.

The guidance is based on clinical trials indicating that HIV-negative people taking a daily dose of oral antiretroviral medication, known as pre-exposure prophylaxis (PrEP), to reduce the risk of infection, is both safe for people to use and effective in preventing HIV.

The iPrEX study shows that use of PrEP can reduce HIV infection by around 40 per cent among men who have sex with men – and up to 73 per cent among those who took the medicine regularly.

The Partners PrEP study found 75 per cent protection among serodiscordant couples (couples in which one person is HIV positive) in Kenya and Uganda.

A WHO statement said the range of results in these studies highlight the potential benefits of PrEP, but also the importance of combining it with consistent use of condoms, as well as frequent HIV testing, counselling, and treatment of sexually transmitted infections.

They also emphasize the importance of taking medicines every day. Many people who are at high risk for HIV may not easily be able to incorporate the diligent treatment regimen required, so the next challenge is to ascertain how best to deliver PrEP to those who would benefit
from it in ‘real life’ settings, in order to achieve the necessary adherence and maximum public health gains.

The United States Food and Drug Administration this week approved the use of ARVs as part of a comprehensive HIV prevention strategy for the country that includes condom use and other safe practices as well as testing and counselling.

The manufacturer of the approved pill estimates that the medicine will typically cost US$13,900 per person per year in the US.

At the Washington conference, WHO will present proposals to accelerate the elimination of HIV transmission, linking the latest science with what can be done on the ground.

This includes a discussion paper on strategic use of antiretrovirals, a global report on drug resistance, guidance on the prevention and treatment of HIV and sexually transmitted infections among sex workers, and guidance on the prevention of hepatitis (a common co-infection with HIV) among people who inject drugs.
-0- PANA SEG 20July2012